Valsartan-Hydrochlorothiazide

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Apr 10, 2024

Warnings

Valsartan Hydrochlorothiazide (Diovan HCT) Risks, Warnings, and Complications

Valsartan hydrochlorothiazide can cause or worsen health problems in some people. Talk to your doctor or pharmacist about taking other blood pressure medicines if you are at a higher risk of adverse reactions from this combination antihypertensive therapy.

FETAL RISK: Valsartan hydrochlorothiazide and other drugs that act on the renin-angiotensin system can be harmful to an unborn baby if they are used during the second and third trimesters of pregnancy. Use of these medications can lead to oligohydramnios (decreased amniotic fluid volume) and impaired kidney function in the developing fetus. This can lead to congenital abnormalities (birth defects). In addition, thiazide diuretics can cross the placenta and cause fetal or neonatal jaundice and thrombocytopenia (low platelet count). Due to the significant fetal risk associated with valsartan hydrochlorothiazide, this medication should not be taken by pregnant women. Tell your doctor if you are pregnant before starting treatment with this combination medicine. Stop taking valsartan hydrochlorothiazide, and call your doctor immediately if you become pregnant while on it.
LOW BLOOD PRESSURE: Taking valsartan hydrochlorothiazide can result in excessive correction of high blood pressure, leading to hypotension (low blood pressure). This is more common in people who are volume or salt-depleted (dehydrated) or have fluid and electrolyte imbalance as well as those taking high doses of the medicine. Low blood pressure is more likely to occur when you first start taking valsartan hydrochlorothiazide and after the dose is increased. Monitor your blood pressure regularly at home. Tell your doctor if you have diarrhea, vomiting, or excessive sweating, which can lead to dehydration and low blood pressure. Call your doctor if you develop severe or persistent dizziness or lightheadedness during treatment.
RENAL IMPAIRMENT: Taking drugs such as a diuretic or inhibitors of the renin-angiotensin system can lead to changes in kidney function, including acute kidney failure. People with certain medical conditions, such as volume depletion, chronic kidney disease, renal artery stenosis, or severe congestive heart failure, are at a particularly high risk of developing acute renal failure on this combination of blood pressure medicine. Tell your doctor if you have a history of kidney problems. Call your doctor immediately if you develop urinary symptoms while on this medicine. Your doctor may monitor renal function periodically during treatment. If you develop signs of significantly compromised renal function, your doctor may recommend temporarily withholding or discontinuing therapy with valsartan hydrochlorothiazide.
ALLERGIC REACTION: Serious hypersensitivity reactions can occur in patients taking valsartan hydrochlorothiazide. The risk of this happening is particularly high in people with a history of bronchial asthma. Seek emergency medical care if you develop difficulty breathing while on this medicine.
SYSTEMIC LUPUS ERYTHEMATOSUS: Thiazide diuretics, including hydrochlorothiazide, can activate or worsen lupus (systemic lupus erythematosus or SLE). Before starting treatment, tell your doctor if you have a history of lupus.
LITHIUM TOXICITY: There are reports of lithium toxicity in patients taking valsartan hydrochlorothiazide. Your doctor will monitor lithium levels if you are on this medicine.
ELECTROLYTE ABNORMALITIES: People taking hydrochlorothiazide can develop hyponatremia (low sodium) and hypokalemia (low potassium). Drugs that inhibit the renin-angiotensin system can cause hyperkalemia (high serum potassium). Your healthcare provider will monitor serum potassium levels periodically while you are on this blood pressure medicine. Keep all your medical and lab appointments during treatment. You may need to discontinue valsartan hydrochlorothiazide if you develop low potassium that is severe enough to cause muscle weakness, irregular heartbeat, or ECG changes.
EYE PROBLEMS: Hydrochlorothiazide can cause eye problems such as acute myopia (shortsightedness) and acute angle-closure glaucoma (increased intraocular pressure, which can lead to vision loss). Tell your doctor if you have allergies to penicillin or sulfa drugs. Stop taking Diovan HCT and tell your doctor immediately if you develop eye pain, redness, swelling, or vision problems.
METABOLIC DISTURBANCES: Hydrochlorothiazide can cause changes in glucose tolerance and elevated blood cholesterol and triglyceride levels. This medication can also trigger gout in susceptible patients by raising serum uric acid levels. Additionally, hydrochlorothiazide can decrease renal clearance of calcium, resulting in high serum calcium. Your doctor may order blood tests periodically to keep an eye on these parameters.

Precautions Before Starting Valsartan Hydrochlorothiazide (Diovan HCT)

Tell your doctor if you have ever had allergic reactions to valsartan, hydrochlorothiazide, any of the active or inactive ingredients in valsartan hydrochlorothiazide tablets, other angiotensin II receptor antagonists, other diuretics, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal products. This will lower the potential risk of interactions between your medications.

Give your health care professional a complete medical history. Valsartan hydrochlorothiazide may not be safe for people with certain medical conditions such as heart disease, kidney disease, liver disease, bile duct blockage, diabetes, asthma, high cholesterol, gout, lupus (SLE), or glaucoma.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are nursing an infant with breast milk. Do not breastfeed while on this medicine.

Precautions During Use of Valsartan Hydrochlorothiazide (Diovan HCT)

Keep all your medical and lab appointments while on this medication. Your healthcare provider may order blood tests to check kidney function and electrolyte levels periodically.

Keep a log of your blood pressure readings at home and bring it to your healthcare appointments. Your doctor may adjust the dose of valsartan hydrochlorothiazide based on your response.

Take valsartan hydrochlorothiazide at least 1 hour before or 4 hours after cholesterol-lowering medications such as colestipol and cholestyramine. Also, take it 3-4 hours before bedtime because hydrochlorothiazide is a diuretic (water pill) and can make you urinate more. Taking it later in the day can lead to nighttime awakenings to urinate.

Valsartan hydrochlorothiazide can make you feel dizzy and cause lightheadedness, drowsiness, and blurred vision. Do not drive, operate machinery, or do any other hazardous activity until you know how it affects you. Avoid drinking alcohol because alcohol can make these side effects worse.

Taking valsartan hydrochlorothiazide can cause dizziness, lightheadedness, and fainting when going from a sitting or lying position to standing. Get out of bed slowly to avoid falls.

Stay well hydrated during treatment with valsartan hydrochlorothiazide. Call your doctor if you develop vomiting, diarrhea, excessive sweating, or are unable to drink enough fluids (this can lead to dehydration and a drop in blood pressure). Tell your doctor immediately if you develop dizziness, weakness, or low blood pressure.

Hydrochlorothiazide can make your skin more sensitive to sunlight and increase the risk of skin cancer. Avoid unnecessary sun exposure and wear sunscreen, sunglasses, and protective clothing when outdoors. Tell your doctor without delay if you notice any new skin growths.

Valsartan hydrochlorothiazide can cause changes in glucose tolerance. If you have diabetes and take medication to control blood sugar levels, talk to your provider about how often you should monitor blood glucose and the need to adjust your diabetes medication dosages.

Do not stop taking valsartan hydrochlorothiazide without talking to your doctor, even if you are symptom-free and your blood pressure is controlled. This medicine only works as long as you continue taking it. Discontinuing it suddenly can lead to dangerously high blood pressure and increase your risk of heart attack and stroke.

Talk to your doctor about using adequate birth control while on this medicine. Tell your doctor immediately if you become pregnant while on valsartan hydrochlorothiazide.

Tell all your healthcare providers you are on valsartan hydrochlorothiazide before any surgery or medical tests, including dental procedures.

Valsartan Hydrochlorothiazide (Diovan HCT) Drug Interactions

Certain other drugs can affect how the combination of valsartan hydrochlorothiazide works. Possible interactions with other medicines can increase the risk of severe adverse reactions.

If you have diabetes, you should not take a blood pressure medication called aliskiren (Tekturna, Tekturna HCT, Tekamlo, in Amturnide) at the same time as valsartan.

The following medications can have interactions with valsartan hydrochlorothiazide:

Angiotensin-converting enzyme (ACE) inhibitors such as lisinopril (in Prinzide, in Zestoretic), captopril (Capoten, in Capozide), enalapril (Vasotec), benazepril (Lotensin, in Lotrel), moexipril (Univasc, in Uniretic), ramipril (Altace), perindopril, (Aceon), fosinopril, quinapril (Accupril, in Accuretic, in Quinaretic), and trandolapril (Mavik, in Tarka)
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve)
Selective COX-2 inhibitors such as celecoxib (Celebrex)
Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune)
Other diuretics or water pills, including potassium-sparing diuretics like spironolactone (Aldactone, in Aldactazide), triamterene (Dyrenium, in Dyazide, in Maxzide), and amiloride (Midamor)
Other drugs used to treat high blood pressure or heart problems
Cholesterol-lowering drugs like gemfibrozil (Lopid)
Potassium supplements and potassium-containing salt substitutes
Barbiturates such as phenobarbital and secobarbital (Seconal)
Antibiotics such as rifampin (Rifadin, Rimactane, in Rifamate, in Rifater)
Antiviral drugs like ritonavir (Norvir)
Corticosteroids such as budesonide (Entocort), betamethasone (Celestone), cortisone (Cortone), fludrocortisone (Florinef), dexamethasone (Decadron, Dexpak, Dexasone, others), hydrocortisone (Cortef, Hydrocortone), prednisolone (Prelone, others), methylprednisolone (Medrol, Meprolone, others), triamcinolone (Azmacort, Aristocort), and prednisone (Meticorten, Deltasone, Sterapred, others)
Corticotropin (H.P., ACTH, Acthar Gel)
Insulin and oral diabetes medications
Lithium (Eskalith, Lithobid)
Pain medications

The above list may not describe all the potential interactions of valsartan hydrochlorothiazide. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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